芒硝外敷护理Chapter 7 Mirabilite topical care
学习目标
1.熟悉芒硝的作用机制
2.掌握芒硝外敷的方法及注意事项
3.掌握以下词汇
peritoneal effusion 腹部渗出
external application 外敷
mirabilite 芒硝
osmosis 渗透作用
freezing point 冰点
absorbability 吸收性
deliquesce 溶解
osmotic pressure 渗透压
inflammatory cytokines 炎性因子
crystallize 结晶
Su Fei is a patient with severe acute pancreatitis.She is conscious, but with huge abdominal bloating pain.CT scan shows massive peritoneal effusion.Li Mei is an ICU nurse.Bai Lu is a newly graduated intern.
Bai Lu: Ms.Li, what is mirabilite?
Li Mei: Well, mirabilite is a traditional Chinese medicine.Its chemical composition is Na2SO4 and other salts, colorless or white with strong osmosis and low freezing point.It has strong absorbability and is extremely easy to deliquesce.It can work for relieving constipation by purgation, moistening dryness, softening hardness, clearing fire, and reducing swelling.
Bai Lu: How does it absorb peritoneal effusion?
Li Mei: The osmotic pressure of mirabilite is significantly higher than that ofhuman tissue.External application ofmirabilite can create a local hypertonic environment.Osmotic pressure is applied to squeeze out tissue water, and promote the absorption of peritoneal effusion.What's more, external application ofmirabilite can accelerate lymph circulation and improve the phagocytosis of reticuloendothelial cells, reduce the infiltration ofwhite blood cells and promote the absorption ofinflammatory cytokines.
Bai Lu: What about its usage and precautions?
Li Mei: Pack 1,000 g mirabilite into a cotton bag, then seal the bag before putting it evenly on the abdomen.Put a sanitary pad outside the cotton bag and cover it with the quilt.After 1 to 2 hours, when mirabilite is crystallized into crystal blocks or bag is wet, replace mirabilite and the bag.The total external application time is 8 to 10 hours per day.
Bai Lu: I see.Now I am going to get mirabilite ready for Su Fei.
译文
苏菲是一个重症急性胰腺炎的患者，神志清，但是腹部剧烈胀痛，CT提示腹腔积液较多。李梅是一名ICU的护士，白露是一名刚毕业的实习生。
白露：李老师，芒硝是什么？
李梅：芒硝是一味中药，它的化学成分主要是Na2SO4等盐类，无色或白色，渗透性强，冰点低，吸收性好，极易潮解。有泻下通便、润燥软坚、清火消肿的功能。
白露：它是怎么吸收腹腔积液呢？
李梅：芒硝的晶体渗透压显著高于人体组织渗透压，芒硝外敷可以在局部形成高渗环境，借助渗透压的作用使组织水分渗出体外，从而促使腹腔积液吸收。而且，芒硝外敷时能加快淋巴循环，提高网状内皮细胞的吞噬功能，减少白细胞浸润，促进炎性细胞因子的吸收。
白露：它的使用方法和注意事项呢？
李梅：芒硝1 000 g，均匀装入棉布袋中，封闭后平铺于腹部，布袋外面放置卫生垫，盖好被子，外敷1～2小时芒硝凝结成结晶块，或棉布袋潮湿，要更换芒硝及布袋，每天外敷总时间8～10小时。
白露：明白了，我这就去给苏菲准备芒硝等物品。